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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393622570
Report Date: 07/19/2019
Date Signed: 07/19/2019 01:50:54 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:MARTIN, LAKISHAFACILITY NUMBER:
393622570
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
07/19/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Lakisha MartinTIME COMPLETED:
02:20 PM
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Licensing Program Analysts (LPAs) Tanya Washington, Charlotte Baney and Chayntel Hunter met with Licensee Lakisha Martin and her spouse for the purpose of a capacity increase of her Family Child Care Home from 8 to 14 children. There were no day-care children present during today's inspection. Licensee received required fire clearance from Stockton Fire Prevention to operate at a maximum capacity of 14 children on 07/03/2019. According to Licensee fire inspector approved the use of the converted garage for day-care. LPAs and Licensee toured all areas of the home that are accessible to children. All individuals subject to criminal background review have obtained a criminal record clearance. Facility operates Monday- Friday from 6:00 AM to 6:00 PM.

Off-limit areas include all three bedrooms and a portion of the backyard. Licensee acknowledged that children may never enter these off-limit areas and she must notify the department if she wishes to make the areas of the home accessible to children. LPAs observed a functioning smoke and carbon monoxide detectors as well as a 2A10BC fire extinguisher.

Capacity increase is approved for a Large Family Child Care Home as of today, July 19, 2019. Facility is now licensed to serve a maximum capacity (when there is an assistant present) of 12 children with no more than four infants OR a capacity of 14 children no more than three Infants; one child must be in Transitional Kindergarten/Elementary School and one child must be at least six years old. If there is not an assistant present, the facility must revert to a Small Family Child Care Home license requirements.

This report was discussed with the Licensee and a Notice of Site visit was provided and posted. No Title 22 deficiencies are observed during today's inspection.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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